In caring for a patient with neutropenia, what tasks can be delegated to the nursing assistant?
- A. Take vital signs every 4 hours
- B. Report temperature elevation >100.4°F
- C. Assess for sore throat, cough, or burning with urination
- D. Gather the supplies to prepare the room for protective isolation
Correct Answer: A
Rationale: Neutropenia heightens infection risk, requiring team vigilance. Taking vital signs every 4 hours fits nursing assistants' scope routine monitoring flags fevers, key in neutropenia, without needing assessment skills. Reporting fever >100.4°F is their duty once detected, but assessing symptoms like sore throat or cough demands RN judgment to interpret infection signs. Gathering supplies for isolation is assistive, not evaluative, suiting their role. Handwashing's universal, not a task to delegate. Vital signs delegation ensures timely data collection, freeing nurses to analyze and act, a practical split in caring for this vulnerable patient.
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Which of the following assessment findings are consistent with aortic stenosis?
- A. Systolic click
- B. Pitting edema
- C. Harsh systolic crescendo decrescendo murmur
- D. Atrial fibrillation
Correct Answer: C
Rationale: Aortic stenosis narrows the valve, obstructing outflow producing a harsh systolic crescendo-decrescendo murmur, loudest at the aortic area, a classic sign from turbulent flow. Systolic clicks tie to mitral prolapse, not stenosis. Pitting edema reflects heart failure, a late complication, not direct. Atrial fibrillation may coexist but isn't specific. Nurses expect this murmur, auscultating for its distinct pattern, key to spotting stenosis early, guiding diagnostics like echocardiography to prevent progression to failure.
A 60 year old lady presents with a skin tear to her left shin on her coffee table. She is unsure of her previous immunization status. How should this be managed?
- A. ADT only
- B. ADT plus immunoglobulin
- C. Immunoglobulin only
- D. Neither
Correct Answer: A
Rationale: Skin tear, unknown shots ADT boosts, no Ig needed for clean cuts, antibiotics if dirty. Nurses jab this chronic tetanus shield solo.
In monitoring patients who are at risk for spinal cord compression related to tumor growth, what is the most likely early manifestation?
- A. Sudden-onset back pain
- B. Motor loss
- C. Constipation
- D. Urinary hesitancy
Correct Answer: A
Rationale: Spinal cord compression from tumors often starts with sudden back pain 95% of cases due to vertebral pressure or nerve irritation, an early red flag demanding urgent imaging and intervention to prevent paralysis. Motor loss, like weakness, emerges later as nerves compress further. Constipation and urinary hesitancy signal advanced autonomic involvement, not initial signs. Pain's prevalence and timing make it the nurse's focus catching it early triggers steroids or surgery, halting progression in cancer patients where spinal integrity dictates function and survival, a critical monitoring priority.
In the UK, orthognathic surgery is likely to:
- A. Be undertaken in specialist craniofacial surgery units rather than in maxillofacial surgery units.
- B. Be associated with a high incidence of postoperative nausea and vomiting.
- C. Require a nasal rather than an oral tracheal tube when a Le Fort I osteotomy is performed.
- D. Require admission of the patient to a high-dependency unit.
Correct Answer: B
Rationale: Orthognathic surgery corrects jaw deformities in the UK, typically by maxillofacial surgeons, not solely craniofacial units (reserved for complex congenital cases). Postoperative nausea and vomiting (PONV) are common due to blood swallowing, prolonged surgery, and opioids risk factors per Apfel criteria. Le Fort I osteotomy (maxillary) often uses oral intubation; nasal tubes suit mandibular focus or surgeon preference, not a requirement. High-dependency unit (HDU) admission isn't routine most recover in general wards unless complications (e.g., airway) arise. Cleft palate repair precedes, not follows, orthognathic work. PONV's prevalence reflects surgical and anaesthetic challenges, necessitating robust antiemetic prophylaxis.
What is the average life expectancy in Canada?
- A. 60 years
- B. 70 years
- C. 80 years
- D. 90 years
Correct Answer: C
Rationale: Canada's life clock hits 80 78.5 for men, 82.7 for women in 2010 a longevity nurses bank on for chronic care spans. Lower guesses lag history; 90's a stretch. It shapes health goals, a timeline framing illness fights.